Antiplatelets

Question 1

brand name

Clopidogrel (P2Y12 Inhibitors)

Answer 1

plavix

Question 2

generic name

Brilinta (P2Y12 Inhibitors)

Answer 2

Ticagrelor

Question 3

brand name

Prasugrel (P2Y12 Inhibitor)

Answer 3

Effient

Question 4

indication

plavix, brilinta, effient (P2Y12 Inhibitors)

Answer 4

coronary artery disease, ischemic stroke, peripheral artery disease

Question 5

MOA

plavix, effient (P2Y12 Inhibitors)

Answer 5

irreversibly and directly inhibits ADP binding to receptor sites, inhibiting subsequent activation of the glycoprotein IIb/IIIa complex

Question 6

MOA

brilinta (P2Y12 Inhibitor)

Answer 6

reversibly and allosterically inhibits ADP binding to receptor sites, inhibiting subsequent activation of the glycoprotein IIb/IIIa complex

Question 7

major contraindications

plavix, brilinta, effient (P2Y12 Inhibitors)

Answer 7

• all: active bleeding
• brinlinta: history of intracranial hemorrhage
• effient: history of any TIA or stroke

Question 8

black box warnings

clopidogrel/plavix (p2y12 inhibitors)

Answer 8

may not be effective with reduced CYP2C19 activity

Question 9

common ADRs

plavix, brilinta, effient (P2Y12 Inhibitors)

Answer 9

minor bleeding

Question 10

rare ADRS

plavix, brilinta, effient (P2Y12 Inhibitors)

Answer 10

• major bleeding (intracranial hemorrhage)
• thrombotic thrombocytopenic purpura

Question 11

key counseling points

plavix, brilinta, effient (P2Y12 Inhibitors)

Answer 11

• Severe bleeding can occur but is rare. It is common to bruise more easily or take a little longer for minor cuts to stop bleeding.
• You should call your doctor if you have dark tarry tools (sign of digested blood), you cough up blood, or have a bleeding cut that won’t stop.
• Avoid taking with NSAIDs

Question 12

brand name

platelet aggregation inhibitor

Answer 12

aggrenox

Question 13

generic name

platelet aggregation inhibitor

Answer 13

dipyridamole/acetylsalicylic acid

Question 14

indication

aggrenox (platelet aggregation inhibitor)

Answer 14

ischemic stroke and transient ischemic attack

Question 15

MOA

aggrenox (platelet aggregation inhibitor)

Answer 15

• Dipyridamole: Inhibits the uptake of adenosine into platelets, endothelial cells, and erythrocytes resulting in an increase in local concentrations of adenosine, which is a coronary vasodilator and a platelet aggregation inhibitor
• Aspirin: Inhibits platelet aggregation by irreversible inhibition of platelet cyclooxygenase and thus inhibits the generation of thromboxane A2 (TXA2)

Question 16

major contraindications

aggrenox (platelet aggregation inhibitor)

Answer 16

asthma

Question 17

common ADRs

aggrenox (platelet aggregation inhibitor)

Answer 17

• headache (~40% of patients, tolerance can be built overtime)
• nausea
• diarrhea

Question 18

rare ADRs

aggrenox (platelet aggregation inhibitor)

Answer 18

• bleeding
• bronchospasm
• drug reaction w/ eosinophilia and systemic symptoms (DRESS)

Question 19

key counseling points

aggrenox (platelet aggregation inhibitor)

Answer 19

• Severe bleeding can occur but is rare. It is common to bruise more easily or take a little longer for minor cuts to stop bleeding.
• You should call your doctor if you have dark tarry tools (sign of digested blood), you cough up blood, or have a bleeding cut that won’t stop.
• Avoid taking with NSAIDs